No parent wants to think that their child may be using drugs or that they may have an addiction, but as addiction and abuse in the U.S. reaches epidemic proportions it is important to stay vigilant. Parents of children and young people on the spectrum are not immune either. There are very few studies exploring this area, but the data that is available suggests that the prevalence of people with autism who have an addiction, range from 0.7% to 36% – a very broad scope. The following information provides parents with a comprehensive insight to the topic, and tips on monitoring and prevention.
Dr. Naoji A. Watson, Psy.D.
Dr. Naoji A. Watson, Psy.D. in Alexandria, Virginia, specializes in autism spectrum disorder (ASD) in both children and adults as well as substance abuse. He feels that substance use and abuse are often a means of coping with distress. In the case of an individual with ASD who began to use, there would be a serious danger if it became so much a part of that person’s coping mechanism that it became negatively reinforced. Rigidity at times with behaviors, a common symptom of ASD, can also increase the risk factors.
The truth is, there simply isn’t enough data available to get a more reliable or tighter range in the prevalence of addiction. A report published in August 2016 by Espen Ajo Arnevik and Sissel Berge Helverschou found that there were only 18 studies exploring the relationship between addiction and autism. They did not find any studies that explored specific treatment interventions.
This leaves parents of children on the spectrum at a distinct disadvantage. Addiction and substance abuse typically do not look the same in a person with autism as they would in someone who doesn’t have the condition. Treatment and recovery are different because of certain traits that autistic individuals often possess. Even the reasons behind the behavior, what drew the person to the substance in the first place, often differs from those who are not on the spectrum. More research is definitely needed.
A Swedish study, published in January 2017, concluded that ASD are a risk factor for problems relating to substance use. They found that ASD doubled the risk of substance abuse in individuals and when there was a comorbidity of attention deficit hyperactive disorder (ADHD), that risk increased even more. ASD with intellectual disability also presents an elevated risk. Furthermore, in families where an ASD individual had a substance abuse problem, family members including siblings, parents, and half siblings also had a greater risk of abusing substances as well. This is vital information that parents need to know in order to protect and preserve not only their ASD children, but their non-ASD children as well.
For many ASD individuals, social interaction is, at the least confusing, awkward, and frustrating, and at the worst, excruciating. As young people mature they begin to seek the company of their peers. A non-ASD person will often make friends and desire the company of others but many people with ASD are introverted and do not have the same need to surround themselves with people. However, they often have a strong desire to “fit in” which means conforming to some societal norms – which means socializing. This is frequently quite adverse to their natural tendencies, but they press on anyway. They may also use substances to escape the effects of sensory overload, the result of sensory processing disorder (SPD).
This is not to say that people with ASD have no desire for relationships, as many of them do. But relationships on the spectrum usually look very different from non-spectrum relationships. One of the most common markers for ASD is social awkwardness. Anxiety and social phobia are frequent comorbidities of ASD and self-medicating in order to calm those feelings is very attractive. It is a way that they can fit in, to feel more “normal” and more comfortable in social situations.
“Addiction is often times a disorder that can occur in a vacuum,” says Dr. Watson. “Whether that is in a home that denies the addiction or in some cases a member that enables the addiction to continue because it may help the member struggling to function somewhat more effectively. Someone with Autism may be in more danger because many of them are already very isolated and becoming an addict while already socially isolated could have devastating impacts because there may already be limited social contacts and supports.”
Many people with ASD, particularly young people, feel disconnected from the rest of the world. Some who have been able to verbalize it have described having a feeling of looking through a window, watching the world but never really being a part of it. These feelings of isolation and feeling like they don’t fit in or aren’t accepted can lead to depression. Then they may seek substances in order to mask that pain.
The sad truth is the alcohol or drugs, while certainly not acceptable, actually do make it easier for individuals with ASD to interact with others and even approach social situations with more ease. They may not seek or utilize a more flexible or adaptive means of coping – they may not even be able to identify them.
Dr. Watson says, “People use substances for different reasons but the effects will be similar to others, I believe. The impact is really in the perception of the individual. Someone with Autism may have different perceptions of the substance use and its impact on their functioning.”
Parents with ASD children can’t rely on the standard signs of addiction. While some may overlap, the ASD child may become less socially aloof and more at ease in social situations. Parents may notice an amazing transformation in their ASD child from quiet loner to more of a social butterfly. Typical symptoms for addiction, such as withdrawal and depression may be quite the opposite for someone with ASD who is abusing substances. They may be less clumsy, less awkward, and seek the company of their peers. While some young people do make these dramatic changes without the use of substances, ASD parents should be wary when the changes come on suddenly or after the child acquires new friends.
In summary:
Dr. Watson offered some valuable insight for parents. “I think warning signs are changes in behaviors or perhaps increased isolation or withdrawal,” he ways. “There may be physiological aspects that may be noticeable such as bloodshot eyes or acting in odd or peculiar ways. This may be hard to differentiate from autism behaviors.”
Substance use or abuse in young people is never OK. While it may appear to “help” the child, that is a very dangerous deception. There are therapies and programs available that can help children with social issues and SPD; they don’t need alcohol or drugs to do it. Rigid behaviors may present a challenge in treatment as can the obsessiveness that could occur if the substance becomes the child’s “special interest.”
“The obsessive quality can be a huge concern especially if the person sees the “benefits” of use as a means of helping them cope with distressing feelings,” Dr. Watson says. “The obsessive behaviors can be a factor that helps an individual with autism cope or soothe their symptoms whether consciously or unconsciously. Addictions can become a maladaptive means of coping.
Typically, ASD individuals don’t relate well to people and don’t have the emotional range of non-ASD individuals which can also be barriers to treatment. More than half of the individuals with ASD have a comorbidity. This also needs to be taken into account when seeking treatment.
Pay attention to your child’s friends. It is often hard for an ASD child to distinguish between someone who is truly their friend and someone who is using or abusing them. They may follow and imitate undesirable behavior simply because they want to keep these “friends” or be like them.
Dr. Watson has this advice for parents. “Be patient and understanding. Show empathy and consistent concern. Of course, being concerned about the addiction, but more importantly it is vital to understand the motivation for the addiction, understanding the deeper feelings.” He says, “I think listening to them and asking them what their substance does for them and how it makes them feel. Making an effort to not be judgment and focusing on understanding the motivation for the use and how it may help them cope with other feelings.”
Sources
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990150/
https://link.springer.com/article/10.1007%2Fs10803-016-2914-2
https://www.omicsonline.org/open-access/addiction-and-autism-a-remarkable-comorbidity-2329-6488.1000170.php?aid=28744
https://therapists.psychologytoday.com/rms/name/Naoji_Andrew_Watson_PsyD_Alexandria_Virginia_223431
http://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=2220&context=honors_theses
